眼睑黏膜相关淋巴组织结外边缘区淋巴瘤二例

Two cases of lymphatic tumors in the extranodal marginal zone of the eyelid mucosa-associated lymphoid tissues

目的探讨眼睑黏膜相关淋巴组织结外边缘区B细胞淋巴瘤的临床病理学特征。方法对2例眼睑黏膜相关淋巴组织结外边缘区淋巴瘤的临床表现、组织学形态及免疫表型进行分析,并复习相关文献。结果镜检下2例均表现为小圆形肿瘤细胞结节状或弥漫浸润生长,肿瘤细胞浸润至横纹肌组织及睑板腺周围,并见淋巴上皮病变,部分区域见滤泡植入现象。高倍镜下细胞大小不等,细胞核呈类圆形及圆形,核凹陷或扭曲,核深染,染色质分布不均,核仁不明显,胞质少,淡染或部分处呈透明状。肿物组织免疫组化表达结果:CD20弥漫(+)、CD79a弥漫(+)、Bcl-2 1例阳性,1例弱阳性、Ki-6710%~20%(+)。结论眼睑黏膜相关淋巴组织结外边缘区淋巴瘤罕见,熟悉其临床病理学特征及免疫表型,有助于正确诊断。

Objective To explore the clinicopathological features of extranodal marginal zone B-cell lymphoma of eyelid mucosa-associated lymphoid tissues.Methods The clinical manifestations,histological features and immunophenotyping of two cases of extranodal marginal zone lymphoma of eyelid mucosa-associated lymphoid tissues were analyzed,and related literatures were reviewed.Results Microscopically,two cases presented nodular or diffuse infiltration of small round tumor cells,tumor cells infiltrated into the striated muscle tissues and around the meibomian gland,and lymphoid epithelial lesions were observed,and follicular implantation was observed in some areas.At high magnification,the cell size varies,the nucleus is round and nearly round,the nucleus is hollow or distorted and the nucleus is deeply stained,the chromatin is unevenly distributed,the nucleolus is not obvious,the cytoplasm is less,lightly stained or part is transparent.Immunohistochemical expression of tumor tissues：CD20 diffuseness（＋）,CD79 a diffuseness（＋）,Bcl-2,1 case was weakly positive,another case was positive and ki-6710% - 20%（＋）.Conclusions The extranodal marginal zone lymphoma of eyelid mucosa-associated lymphoid tissue are rare and familiarity with its clinical and pathological features also immunophenotype is helpful for correct diagnosis.